Ferrari Cagidiaco Edoardo, Verniani Giulia, Pontoriero Denise Irene Karin, Saracutu Ovidiu Ionut, Manfredini Daniele, Ferrari Marco
Department of Medical Biotechnologies, Division of Fixed Prosthodontics and Dental Materials, University of Siena, Siena, Italy.
Department of Medical Biotechnologies, Division of TMJ and Oral Pain, University of Siena, Siena, Italy.
J Dent. 2025 Oct;161:106005. doi: 10.1016/j.jdent.2025.106005. Epub 2025 Jul 28.
These randomized controlled clinical aims to evaluate the long-term clinical performance of posterior lithium disilicate partial crowns used to restore endodontically treated teeth (ETT), with or without fiber post placement, over a 9-year period in patients who did not report any bruxism activities at baseline.
Participants were recruited at the University of Siena, Siena, Italy. Patient were≥18 years, in need for one partial crown on posterior teeth (molars and premolars) following endodontic treatment and with at least 50 % of the coronal structure remaining. Patients were randomly assigned to two groups: Group 1 received fiber posts for abutment build-up, and Group 2 did not. Lithium disilicate partial crowns were fabricated and adhesively cemented for both groups. Clinical and radiographic evaluations were conducted at baseline, 1, 2, 3, and 9 years. Failures were defined as post debonding/fracture, root fracture, crown dislodgement/fracture, or the presence of periapical lesion. Cox regression analysis was used to assess the influence of post placement and tooth type.
A total of 120 patients were enrolled. At the 9-year follow-up, survival of ETT ranged between 88.8 % in molars without post and to 85.7 % in premolars with no post. No statistically significant difference was observed regarding post placement or tooth type on failure rates (p > .05).
The findings of the present clinical trial support the idea in patients with no report of bruxism, the insertion of a fiber post for the reconstruction of endodontically treated teeth with partial crown lithium disilicate in posterior teeth is not a necessary procedure.
When at least 50 % of coronal structure is maintained, fiber post placement does not significantly influence survival rates. Lithium disilicate partial crowns provide excellent long-term outcomes in restoring endodontically treated posterior teeth.
这些随机对照临床试验旨在评估在9年时间里，用于修复根管治疗牙（ETT）的后牙锂二硅酸盐全冠，无论是否放置纤维桩，在基线时未报告有磨牙活动的患者中的长期临床性能。
参与者在意大利锡耶纳大学招募。患者年龄≥18岁，根管治疗后需要在后牙（磨牙和前磨牙）上制作一个全冠，且冠部结构至少保留50%。患者被随机分为两组：第1组接受纤维桩用于基牙修复，第2组不接受。两组均制作锂二硅酸盐全冠并粘结固定。在基线、1年、2年、3年和9年进行临床和影像学评估。失败定义为桩脱粘/折断、牙根折断、冠脱位/折断或根尖周病变的存在。采用Cox回归分析评估桩的放置和牙齿类型的影响。
共招募了120名患者。在9年随访时，根管治疗牙的生存率在未放置桩的磨牙中为88.8%，在未放置桩的前磨牙中为85.7%。在失败率方面，未观察到桩的放置或牙齿类型有统计学显著差异（p>0.05）。
本临床试验的结果支持这样的观点，即在没有磨牙症报告的患者中，在后牙用锂二硅酸盐全冠修复根管治疗牙时插入纤维桩不是必要的步骤。
当冠部结构至少保留50%时，纤维桩的放置不会显著影响生存率。锂二硅酸盐全冠在修复根管治疗后的后牙方面提供了优异的长期效果。
